Benefit Booklet 2024
Accident 1.0 -Preferred with Health Screening BenetAccidents happen in places where you and your family spend the most time – at work, in the home and on the playground – and they’re unexpected. How you care for them shouldn’t be. In your lifetime, which of these accidental injuries have happened to you or someone you know?l Sports-related accidental injuryl Broken bonel Burnl Concussionl Lacerationl Back or knee injuriesColonial Life’s Accident Insurance is designed to help you ll some of the gaps caused by increasing deductibles, co-payments and out-of-pocket costs related to an accidental injury. The benet to you is that you may not need to use your savings or secure a loan to pay expenses. Plus you’ll feel better knowing you can have greater nancial security.l Car accidentsl Falls & spillsl Dislocationl Accidental injuries that send you to the Emergency Room, Urgent Care or doctor’s oceWhat additional features are included?l Worldwide coveragel Portablel Compliant with Healthcare Spending Account (HSA) guidelinesWill my accident claim payment be reduced if I have other insurance?You’re paid regardless of any other insurance you may have with other insurance companies, and the benets are paid directly to you (unless you specify otherwise).What if I change employers?If you change jobs or leave your employer, you can take your coverage with you at no additional cost. Your coverage is guaranteed renewable as long as you pay your premiums when they are due or within the grace period. Can my premium change?Colonial Life can change your premium only if we change it on all policies of this kind in the state where your policy was issued. How do I le a claim?Visit coloniallife.com or call our Customer Service Department at 1.800.325.4368 for additional information.Accident Insurance
Your Colonial Life policy also provides benets for the following injuries received as a result of a covered accident.l Burn (based on size and degree) ....................................................................................$1,000 to $12,000l Coma .............................................................................................................................................................$10,000l Concussion .......................................................................................................................................................$150l Emergency Dental Work .......................................$75 Extraction, $300 Crown, Implant, or Denturel Lacerations (based on size) ........................................................................................................... $50 to $800Requires Surgeryl Eye Injury ...........................................................................................................................................................$300l Tendon/Ligament/Rotator Cu .......................................................... $500 - one, $1,000 - two or morel Ruptured Disc ..................................................................................................................................................$500l Torn Knee Cartilage .......................................................................................................................................$500Surgical Carel Surgery (cranial, open abdominal or thoracic) ................................................................................$1,500l Surgery (hernia) ..............................................................................................................................................$150l Surgery (arthroscopic or exploratory) ....................................................................................................$250l Blood/Plasma/Platelets ................................................................................................................................$300Benets listed are for each covered person per covered accident unless otherwise specied.Initial Carel Accident Emergency Treatment........... $150 l Ambulance .......................................$400l X-ray Benet ...................................................$50 l Air Ambulance ............................. $2,000Common Accidental InjuriesDislocations (Separated Joint) Non-Surgical SurgicalHip $6,600 $13,200 Knee (except patella) $3,300 $6,600 Ankle – Bone or Bones of the Foot (other than Toes) $2,640 $5,280 Collarbone (Sternoclavicular) $1,650 $3,300 Lower Jaw, Shoulder, Elbow, Wrist $990 $1,980 Bone or Bones of the Hand $990 $1,980 Collarbone (Acromioclavicular and Separation) $330 $660 One Toe or Finger $330 $660 Fractures Non-Surgical Surgical Depressed Skull $5,500 $11,000 Non-Depressed Skull $2,200 $4,400 Hip, Thigh $3,300 $6,600 Body of Vertebrae, Pelvis, Leg $1,650 $3,300 Bones of Face or Nose (except mandible or maxilla) $770 $1,540 Upper Jaw, Maxilla $770 $1,540 Upper Arm between Elbow and Shoulder $770 $1,540 Lower Jaw, Mandible, Kneecap, Ankle, Foot $660 $1,320 Shoulder Blade, Collarbone, Vertebral Process $660 $1,320 Forearm, Wrist, Hand $660 $1,320 Rib $550 $1,100 Coccyx $440 $880 Finger, Toe $220 $440
Transportation/Lodging AssistanceIf injured, covered person must travel more than 50 miles from residence to receive special treatment and connement in a hospital.l Transportation ............................................................................. $500 per round trip up to 3 round tripsl Lodging (family member or companion) ............................................... $125 per night up to 30 days for a hotel/motel lodging costsAccident Hospital Carel Hospital Admission* ........................................................................................................$1,500 per accidentl. Hospital ICU Admission* ................................................................................................$3,000 per accident* We will pay either the Hospital Admission or Hospital Intensive Care Unit (ICU) Admission, but not both.l Hospital Connement .........................................................$250 per day up to 365 days per accidentl Hospital ICU Connement ...................................................$500 per day up to 15 days per accidentAccident Follow-Up Carel Accident Follow-Up Doctor Visit ..........................................................$50 (up to 3 visits per accident)l Medical Imaging Study ......................................................................................................$250 per accident (limit 1 per covered accident and 1 per calendar year)l Occupational or Physical Therapy ..................................................... $35 per treatment up to 10 daysl Appliances ..........................................................................................$125 (such as wheelchair, crutches)l Prosthetic Devices/Articial Limb ....................................................$500 - one, $1,000 - more than 1l Rehabilitation Unit .................................................$100 per day up to 15 days per covered accident, and 30 days per calendar year. Maximum of 30 days per calendar yearAccidental Dismembermentl Loss of Finger/Toe .................................................................................$750 – one, $1,500 – two or morel Loss or Loss of Use of Hand/Foot/Sight of Eye .....................$7,500 – one, $15,000 – two or moreCatastrophic AccidentFor severe injuries that result in the total and irrecoverable:l Loss of one hand and one foot l Loss of the sight of both eyesl Loss of both hands or both feet l Loss of the hearing of both earsl Loss or loss of use of one arm and one leg or l Loss of the ability to speakl Loss or loss of use of both arms or both legs Named Insured ................ $25,000 Spouse ..............$25,000 Child(ren) ......... $12,500365-day elimination period. Amounts reduced for covered persons age 65 and over. Payable once per lifetime for each covered person. Accidental DeathAccidental Death Common Carrierl Named Insured $25,000 $100,000l Spouse $25,000 $100,000l Child(ren) $5,000 $20,000
EXCLUSIONS We will not pay benets for losses that are caused by or are the result of: hazardous avocations; felonies or illegal occupations; racing; semi-professional or professional sports; sickness; suicide or self-inicted injuries; war or armed conict; in addition to the exclusions listed above, we also will not pay the Catastrophic Accident benet for injuries that are caused by or are the result of: birth; intoxication.For cost and complete details, see your Colonial Life benets counselor. Applicable to policy form Accident 1.0-HS-NC. This is not an insurance contract and only the actual policy provisions will control. Colonial Life 1200 Colonial Life BoulevardColumbia, South Carolina 29210coloniallife.com71740-NC©2014 Colonial Life & Accident Insurance Company | Colonial Life insurance products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 6-14Health Screening Benet l $50 per covered person per calendar yearProvides a benet if the covered person has one of the health screening tests performed. This benet is payable once per calendar year per person and is subject to a 30-day waiting period.Tests include:l. Blood test for triglyceridesl. Bone marrow testingl. Breast ultrasoundl. CA 15-3 (blood test for breast cancer) l. CA125 (blood test for ovarian cancer) l. Carotid doppler l. CEA (blood test for colon cancer) l. Chest x-ray l. Colonoscopy l. Echocardiogram (ECHO) l. Electrocardiogram (EKG, ECG) l. Fasting blood glucose test l. Flexible sigmoidoscopy l. Hemoccult stool analysisl. Mammographyl. Pap smearl. PSA (blood test for prostate cancer)l. Serum cholesterol test to determine level of HDL and LDL l. Serum protein electrophoresis (blood test for myeloma) l. Stress test on a bicycle or treadmill l. Skin cancer biopsy l. Thermography l. ThinPrep pap test l. Virtual colonoscopy Accident 1.0 -Preferred with Health Screening BenetMy Coverage Worksheet (For use with your Colonial Life benets counselor) Who will be covered? (check one) Employee Only Spouse Only One Child Only Employee & Spouse One-Parent Family, with Employee One-Parent Family, with Spouse Two-Parent FamilyWhen are covered accident benets available? (check one) On and O -Job Benets O -Job Only Benets
Specified Critical Illness Insurance If you re diagnosed with a covered critical illness or cancer specified critical illness insurance from Colonial Life can help with your expenses so you can concentrate on what s most important your treatment care and recovery Face amount ___1_0_k_ _2_0_k_ _3_0_k__ Critical illness benefit FOR THE DIAGNOSIS OF THIS COVERED CRITICAL ILLNESS CONDITION THIS PERCENTAGE OF THE FACE AMOUNT IS PAYABLE Cancer 100 Heart attack myocardial infarction 100 Stroke2 100 End stage renal kidney failure 100 Major organ failure 100 Permanent paralysis due to a covered accident 100 Coma 100 Blindness 100 Occupational infectious HIV or occupational infectious hepatitis B C or D 100 Coronary artery bypass graft surgery disease3 25 Carcinoma in situ 25 The maximum benefit amount for this policy is 3x the face amount for the named insured for all covered persons combined The policy will terminate when the maximum benefit amount for specified critical illness has been paid CRITICAL ILLNESS 1 0 WITH CANCER AND SUBSEQUENT DIAGNOSIS
Specified Critical Illness Insurance Exclusions limitations and additional disclosures State specific variations on exclusions AK Alcoholism or Drug Addiction Exclusion does not apply CT Alcoholism or Drug Addiction Exclusion replaced with Intoxication or Drug Addiction Felonies or Illegal Occupations replaced with Felonies DE Alcoholism or Drug Addiction Exclusion does not apply FL Alcoholism or Drug Addiction Exclusion does not apply Psychiatric or Psychological Condition Exclusion does not apply ID Alcoholism or Drug Addiction Exclusion does not apply Psychiatric or Psychological Condition Exclusion replaced with Mental or Emotional Disorders IN Accidents or Sicknesses Occurring While the Policy is not In Force Exclusion added KY Alcoholism or Drug Addiction Exclusion does not apply Hallucinogenics added to Intoxicants and Narcotics Exclusion MD Alcoholism or Drug Addiction Exclusion does not apply Felonies or Illegal Occupations Exclusion does not apply Intoxicants and Narcotics Exclusion does not apply Suicide or Self Inflicted Injuries Exclusion replaced with Self Destruction or Self Inflicted Injuries MO Alcoholism or Drug Addiction Exclusion replaced with Drug Addiction Felonies or Illegal Occupations Exclusion replaced with Illegal Activities NH Intoxicants and Narcotics exclusion does not apply NJ Alcoholism or Drug Addiction replaced with Drug Addiction Felonies or Illegal Occupations Exclusion replaced with Felonies or Illegal Jobs Psychiatric or Psychological Condition Exclusion replaced with Mental or Emotional Disease or Disorder OR Alcoholism or Drug Addiction Exclusion does not apply Intoxicants and Narcotics Exclusion does not apply Suicide or Self Inflicted Injuries Exclusion does not apply Felonies or Illegal Occupations Exclusion replaced with Felonies SC Alcoholism or Drug Addiction Exclusion does not apply Psychiatric or Psychological Condition Exclusion replaced with Mental or Emotional Disorders SD Alcoholism or Drug Addiction Exclusion does not apply Intoxicants and Narcotics Exclusion does not apply TX Alcoholism or Drug Addiction Exclusion does not apply UT Alcoholism or Drug Addiction Exclusion replaced with Alcoholism VT Alcoholism or Drug Addiction Exclusion does not apply Intoxicants and Narcotics Exclusion does not apply Psychiatric or Psychological Condition Exclusion does not apply War or Armed Conflict Exclusion replaced with War State specific pre existing condition limitations FL 12 12 Pre existing Condition means having a sickness or physical condition that during the 12 months immediately preceding the Policy Coverage Effective Date of this policy had manifested itself in such a manner as would cause an ordinarily prudent person to seek medical advice diagnosis care or treatment or for which medical advice diagnosis care or treatment was recommended or received IA 12 12 Pre existing Condition means having a condition for which medical advice or treatment or medication was recommended by a physician or received from a physician within 12 months preceding the Policy Coverage Effective Date of the covered person s policy MD 12 12 Pre existing Condition means having a sickness or physical condition for which any covered person was treated had medical testing received medical advice or had taken medication within 12 months before the Policy Coverage Effective Date of this policy A condition admitted or disclosed on the application will be covered unless the disease or condition is excluded by name or specific description effective on the date of loss NC 12 12 Pre existing Condition means having a sickness or physical condition for which any covered person was treated had medical testing received medical advice or had taken medication within 12 months before the Policy Coverage Effective Date of this policy If a covered person is 65 or older when this policy is issued pre existing conditions for that covered person will include only conditions specifically eliminated by rider NH 6 6 Pre existing condition means having a sickness or physical condition for which any covered person was diagnosed treated had medical testing or received medical advice within 6 months before the Policy Coverage Effective Date of this policy NJ 6 6 Pre existing Condition means having a sickness or physical condition for which any covered person was treated had medical testing received medical advice or had taken medication within six months before the Policy Coverage Effective Date of this policy NV 6 12 Pre existing Condition means having a sickness or physical condition for which any covered person was treated had medical testing received medical advice or had taken medication within six months before the Policy Coverage Effective Date of this policy
In the U S medical spending in the last 12 months of life is nearly 80 000 per person HealthAffairs org End Of Life Medical Spending In Last Twelve Months Of Life Is Lower Than Previously Reported July 2017 Your cost will vary based on the level of coverage you select Talk with your benefits counselor for information about what level of coverage would work best for you Whole Life Insurance You can t predict your family s future but you can be prepared for it You like to think that you ll be there for your family in the years to come But if something happened to you would your family have the income they need It s not easy to think about such serious circumstances but it s important to make sure your family is financially protected You can gain peace of mind with whole life insurance from Colonial Life Advantages of whole life insurance Permanent coverage that stays the same throughout the life of the policy Guaranteed level premiums that do not increase because of changes in health or age Access to the policy s cash value through a policy loan for emergencies1 Benefit for the beneficiary that is typically tax free Benefits and features Two plan options to choose what age your premium payments will end Paid Up at Age 70 or Paid Up at Age 100 Stand alone spouse policy available whether or not you buy a policy for yourself Flexibility to keep the policy if you change jobs or retire Built in terminal illness accelerated death benefit that provides up to 75 of the policy s death benefit up to 150 000 if you re diagnosed with a terminal illness2 Immediate 3 000 claim payment that can help your designated beneficiary pay for funeral costs or other expenses Pays cash surrender value at age 100 when the policy endows WHOLE LIFE IWL5000
Chrisitan Tours Deductions per year 52 Accident 1 0 for NC l On Off Job Accident Coverage Preferred with health screening These rates were prepared on 10 16 2024 and are valid for 90 days Applicable to policy forms ACCIDENT 1 0 HS and ACCIDENT 1 0 NS ISSUE AGE 17 80 NAMED INSURED 4 88 EMPLOYEE SPOUSE ONE PARENT FAMILY TWO PARENT FAMILY 6 69 7 54 9 34 Critical Illness 1 0 for NC l with Subsequent Diagnosis Coverage Health Screening Benefit Cancer Benefit Non Tobacco Rates ISSUE AGE NAMED INSURED EMPLOYEE SPOUSE ONE PARENT FAMILY 10 000 20 000 30 000 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 70 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 70 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 70 1 45 1 91 2 39 3 11 3 73 4 86 6 73 8 28 10 95 13 01 2 39 3 32 4 28 5 72 6 96 9 22 12 96 16 05 21 41 25 52 3 34 4 72 6 18 8 32 10 19 13 58 19 19 23 83 31 86 38 02 2 19 2 91 3 64 4 75 5 70 7 48 10 34 12 71 16 82 19 98 3 62 5 05 6 53 8 74 10 64 14 19 19 91 24 67 32 88 39 21 5 05 7 20 9 41 12 74 15 58 20 91 29 49 36 62 48 94 58 43 1 82 2 28 2 76 3 48 4 10 5 25 7 10 8 67 11 35 13 42 3 13 4 05 5 02 6 45 7 70 10 01 13 70 16 84 22 19 26 35 4 45 5 83 7 28 9 43 11 30 14 76 20 30 25 01 33 04 39 27 Applicable to policy form CI 1 0 TWO PARENT FAMILY 2 58 3 30 4 04 5 14 6 09 7 84 10 71 13 11 17 21 20 40 4 41 5 84 7 31 9 53 11 42 14 93 20 65 25 45 33 67 40 04 6 23 8 38 10 59 13 91 16 75 22 01 30 60 37 80 50 12 59 68 Page 1 of 3 Underwritten by Colonial Life Accident Insurance Company See page 3 for Important Notice
Chrisitan Tours Continued Critical Illness 1 0 for NC l with Subsequent Diagnosis Coverage Health Screening Benefit Cancer Benefit Tobacco Rates ISSUE AGE 10 000 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 70 20 000 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 70 30 000 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 70 NAMED INSURED 1 84 2 60 3 55 4 68 5 85 7 52 10 22 12 98 16 56 19 86 3 18 4 70 6 59 8 85 11 21 14 53 19 93 25 47 32 62 39 22 4 52 6 80 9 64 13 03 16 56 21 55 29 65 37 95 48 68 58 58 EMPLOYEE SPOUSE 2 81 3 99 5 44 7 18 9 00 11 56 15 69 19 94 25 43 30 51 4 87 7 22 10 13 13 59 17 24 22 36 30 62 39 11 50 10 60 25 6 92 10 45 14 81 20 01 25 48 33 16 45 55 58 29 74 77 90 00 ONE PARENT FAMILY 2 23 2 99 3 94 5 07 6 25 7 91 10 61 13 35 16 95 20 28 3 96 5 48 7 38 9 64 11 99 15 32 20 72 26 21 33 41 40 05 5 69 7 98 10 82 14 21 17 74 22 72 30 82 39 06 49 86 59 83 Applicable to policy form CI 1 0 TWO PARENT FAMILY 3 21 4 36 5 84 7 57 9 39 11 93 16 08 20 31 25 82 30 92 5 65 7 96 10 91 14 38 18 02 23 10 31 41 39 85 50 88 61 08 8 10 11 56 15 99 21 18 26 65 34 27 46 73 59 40 75 94 91 24 Page 2 of 3 Underwritten by Colonial Life Accident Insurance Company See page 3 for Important Notice
Chrisitan Tours Continued Whole Life Plus IWL5000 for NC l Adult Base Plan Paid Up at Age 100 Non Tobacco Rates ISSUE AGE 25 000 25 5 31 35 7 22 45 11 47 55 18 72 65 33 32 Tobacco Rates ISSUE AGE 25 35 45 55 65 25 000 9 27 11 28 16 79 28 31 48 41 50 000 10 62 14 44 22 94 37 44 66 63 50 000 18 54 22 56 33 59 56 61 96 82 75 000 15 92 21 66 34 41 56 16 99 95 75 000 27 81 33 84 50 38 84 92 145 23 Applicable to policy forms ICC19 IWL5000 70 IWL5000 70 ICC19 IWL5000 100 IWL5000 100 ICC19 IWL5000J IWL5000J and rider forms ICC19 R IWL5000 STR R IWL5000 STR ICC19 R IWL5000 CTR R IWL5000 CTR ICC19 R IWL5000 WP R IWL5000 WP ICC19 R IWL5000 ACCD R IWL5000 ACCD ICC19 R IWL5000 CI R IWL5000 CI ICC19 R IWL5000 CC R IWL5000 CC ICC19 R IWL5000 GPO R IWL5000 GPO ICC23 IWL5000 LTC IWL5000 LTC 100 000 21 23 28 88 45 88 74 88 133 26 100 000 37 08 45 11 67 17 113 23 193 65 Important Notice Insurance coverage has exclusions and limitations that may affect benefits payable For a complete description of benefits limitations and exclusions please refer to an outline of coverage sample policy certificate proposal description or see your Colonial Life benefits counselor Coverage type benefits and rates vary by state Coverage may not be available in all states Rates provided are illustrative and your actual premium may be different depending on your particular situation and plan choices Colonial Life products are underwritten by Colonial Life Accident Insurance Company for which Colonial Life is the marketing brand 2024 Colonial Life Accident Insurance Company Colonial Life and the Colonial Life logo separately and in combination are service marks of Colonial Life Accident Insurance Company All rights reserved Shelley Hartsell Shelley Hartsell coloniallifesales com 704 883 4838 Page 3 of 3 Underwritten by Colonial Life Accident Insurance Company See page 3 for Important Notice
How to File a Claim for Colonial Life Benefits FOR FASTEST RESULTS FILE ONLINE 1 Go to ColonialLife com access to login or register 2 Fill out the required information and click Submit 3 Enjoy streamlined claims management and faster service online DIGITALLY FILE ALL TYPES OF CLAIMS Disability Insurance Accident Hospital Insurance Life Insurance Critical Illness Cancer Insurance Wellness benefits for screening tests Not sure which type of claim to file No problem Just answer a few questions on the portal and we ll help you figure everything out BEFORE YOU FILE Review the appropriate claims checklist at ColonialLife com and have this information handy to make the process go smoothly Proper documentation must be submitted when filing your claim AFTER YOU FILE Check your claim status and manage your claim by logging into your account at ColonialLife com access Live chat is also available 9 a m 5 p m EST OTHER WAYS TO FILE A CLAIM Fax 1 800 880 9325 Mail P O Box 100195 Columbia SC 29202 Colonial Life is committed to providing you our valued customer a market leading claims experience We look forward to serving you on ColonialLife com On the policyholder portal you can View benefit details Here you ll find a copy of your policy to see what s covered and benefit amounts Track your claim Log in anytime to view status or opt in to receive status alerts by email or text so you know instantly if we require additional information Sign up for direct deposit to get approved payments up to a week faster than paper check Colonial Life insurance products are underwritten by Colonial Life Accident Insurance Company Columbia SC 2022 Colonial Life Accident Insurance Company All rights reserved Colonial Life is a registered trademark and marketing brand of Colonial Life Accident Insurance Company ADR 1312251
Thank you Shelley Hartsell Benefit Specialist 704 883 4838 Shelley Hartsell ColonialLifesales com